Provider Demographics
NPI:1477727154
Name:CRAWFORD, PAULETTE ELAINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:ELAINE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 SW GRAND RESERVES BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2339
Mailing Address - Country:US
Mailing Address - Phone:571-214-0058
Mailing Address - Fax:
Practice Address - Street 1:826 SW GRAND RESERVES BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2339
Practice Address - Country:US
Practice Address - Phone:571-214-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022078911835P1200X, 183500000X, 1835P1200X
FLPS599371835P1200X, 183500000X, 1835P1200X
DCPH1000005331835P1200X
MD187011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Yes183500000XPharmacy Service ProvidersPharmacist